Intelligent prior authorization has an 85 to 90% auto-approval rate

Information is extracted in real time, speeding up the process to approve or to ensure medical necessity is met, says Dr. Traci Granston, VP of clinical strategy at Cohere Health.

Information is extracted in real time, speeding up the process to approve or to ensure medical necessity is met, says Dr. Traci Granston, VP of clinical strategy at Cohere Health.

8:09

8:37

Tech and payer collaboration modernizes prior authorization

Automated electronic PA process uses FHIR interoperability for greater efficiency, says Greg LeGrow, executive director of Payer Product Market Strategy at athenahealth and Mark Fleming, senior director of Product at Availity.

Tech and payer collaboration modernizes prior authorization

Automated electronic PA process uses FHIR interoperability for greater efficiency, says Greg LeGrow, executive director of Payer Product Market Strategy at athenahealth and Mark Fleming, senior director of Product at Availity.

8:37

3:38

Price transparency app aims to help patients lower their medical bills

Cody Coonradt, CEO and founder of Billy, discusses how patients, advocates and insurance agents use the company's app, which displays hospital pricing data by location, to negotiate prices for medical procedures.

Price transparency app aims to help patients lower their medical bills

Cody Coonradt, CEO and founder of Billy, discusses how patients, advocates and insurance agents use the company's app, which displays hospital pricing data by location, to negotiate prices for medical procedures.

3:38

14:22

AI bridges connectivity between payers and providers

Oron Afek, CEO of Vim, works on the provider side and Ashok Chennuru, global chief data and insights officer at Elevance Health, works on the payer side toward scaling artificial intelligence for automation.

AI bridges connectivity between payers and providers

Oron Afek, CEO of Vim, works on the provider side and Ashok Chennuru, global chief data and insights officer at Elevance Health, works on the payer side toward scaling artificial intelligence for automation.

14:22

7:21

European strategies on digital therapeutics

Alberta Spreafico, senior vice president of health innovation at Eversana, explains how the company, along with the Digital Therapeutics Alliance, analyzes, maps and reports on reimbursement frameworks in Europe for digital therapeutics.

European strategies on digital therapeutics

Alberta Spreafico, senior vice president of health innovation at Eversana, explains how the company, along with the Digital Therapeutics Alliance, analyzes, maps and reports on reimbursement frameworks in Europe for digital therapeutics.

7:21

5:32

Why providers can't rely on single vendors for RCM

Greg Surla, senior vice president and chief information security officer for FinThrive, explains why the Change Healthcare cyberattack was a watershed moment and how federal cybersecurity performance goals tie into redundancy essentials.

Why providers can't rely on single vendors for RCM

Greg Surla, senior vice president and chief information security officer for FinThrive, explains why the Change Healthcare cyberattack was a watershed moment and how federal cybersecurity performance goals tie into redundancy essentials.

5:32

6:01

Streamlining the claims adjudication process for health systems

Sal Lo, CEO of Jorie AI, talks about how the company's automated claims adjudication product reduces administrative workload and helps healthcare organizations, including the VA, speed up eligibility verification and claims processing.

Streamlining the claims adjudication process for health systems

Sal Lo, CEO of Jorie AI, talks about how the company's automated claims adjudication product reduces administrative workload and helps healthcare organizations, including the VA, speed up eligibility verification and claims processing.

6:01

10:06

Hospital financials after COVID-19 must address workforce

Burnout, staffing and employee issues need to be addressed in a less fragmented way, says QGenda Chief Innovation Officer Rich Miller.

Hospital financials after COVID-19 must address workforce

Burnout, staffing and employee issues need to be addressed in a less fragmented way, says QGenda Chief Innovation Officer Rich Miller.

10:06

5:42

New partnership simplifies the transition to value-based care

David Wolf, MedeAnalytics AVP, and Lynn Carroll, HSBlox COO, discuss their companies' collaboration, which will help healthcare payers and providers streamline data sharing and stakeholder communication as they adopt new reimbursement models.

New partnership simplifies the transition to value-based care

David Wolf, MedeAnalytics AVP, and Lynn Carroll, HSBlox COO, discuss their companies' collaboration, which will help healthcare payers and providers streamline data sharing and stakeholder communication as they adopt new reimbursement models.

5:42

5:17

Personalized, proactive communication reduces patients' medical bill stress

Ryne Natzke, chief revenue officer at TrustCommerce, a Sphere company, talks about how digital tools can provide patients with customized payment plans for unexpected bills and treat them with dignity along their financial journey.

Personalized, proactive communication reduces patients' medical bill stress

Ryne Natzke, chief revenue officer at TrustCommerce, a Sphere company, talks about how digital tools can provide patients with customized payment plans for unexpected bills and treat them with dignity along their financial journey.

5:17

13:55

Medicare Advantage plans look to health equity reward in star ratings

MA plans will need to measure performance ahead of 2027 when CMS will start rewarding plans that demonstrate progress in addressing health disparities, says Anna Basevich, SVP of Enterprise Partnerships and Customer Enablement at Arcadia.

Medicare Advantage plans look to health equity reward in star ratings

MA plans will need to measure performance ahead of 2027 when CMS will start rewarding plans that demonstrate progress in addressing health disparities, says Anna Basevich, SVP of Enterprise Partnerships and Customer Enablement at Arcadia.

13:55

9:57

ACO Primary Care Flex Model is expected to attract smaller organizations

The model allows for a gradual approach to risk for more conservative and less experienced ACOs, in comparison to ACO REACH, which requires a greater tolerance for risk but has more rewards, says David Morris, EVP at Cedar Gate Technologies.

ACO Primary Care Flex Model is expected to attract smaller organizations

The model allows for a gradual approach to risk for more conservative and less experienced ACOs, in comparison to ACO REACH, which requires a greater tolerance for risk but has more rewards, says David Morris, EVP at Cedar Gate Technologies.

9:57

Finance/RCM (56)